Supreme Court upholds trans access to health care

The Supreme Court has confirmed a temporary injunction against the state’s prohibition on gender-affirming care for transgender youth. This marks the first instance of such a decision by a state supreme court in the country, according to ‘LGBTQ Nation’.

“I will never understand why my representatives are working to strip me of my rights and the rights of other transgender kids,” stated Phoebe Cross, a trans boy and the lead plaintiff. “Living as a trans teenager is challenging enough; the last thing me and my peers need is to have our rights taken away.”

Last year, several trans teenagers, their families, and two medical providers filed a lawsuit following Montana’s passage of a law that prohibited trans teens, but not cisgender teens, from receiving gender-affirming care. The debate in the state legislature was intense, with Republicans voting to ban state Rep. Zooey Zephyr (D)—Montana's first trans lawmaker—from the state house floor after she remarked that her Republican colleagues would have “blood on your hands” for backing the bill.

The plaintiffs contended that the law constitutes illegal sex discrimination, as it prohibits certain treatments solely based on the patient’s sex assigned at birth. For instance, a cisgender teenage boy could receive hormone therapy if his puberty doesn’t align with typical male development, whereas a trans teenage boy in the same scenario would be denied care, with the only difference being their sex assigned at birth.

The plaintiffs’ parents argued that the law infringes upon their constitutional right to make medical decisions for their children, a right generally supported by conservatives, except in cases involving transgender children.

Gender-affirming care is endorsed by all major U.S.A. medical organisations. Two medical providers joined the lawsuit, claiming it hinders them from delivering effective and necessary care.

In September 2023, a lower court judge halted the law’s implementation, stating it was “unlikely to survive any level of constitutional review” and warning that “barring access to gender-affirming care would negatively impact the mental and physical health of gender dysphoric minors.” The judge criticised the state legislature as “disingenuous” in its professed intent to protect minors.

In this decision on December 11th, the state supreme court concurred that the ban on gender-affirming care likely violates the constitution.

“This establishes the state as the first Supreme Court to affirm that trans medical care is protected,” noted trans journalist Erin Reed. “This holds true regardless of any decisions by the US Supreme Court.”

“Fortunately, the Montana Supreme Court acknowledges the risk of state interference in crucial healthcare,” stated Kell Olson of Lambda Legal. Lambda Legal worked with the ACLU and the ACLU of Montana on the lawsuit. “Given that Montana’s constitutional protections are even stronger than federal standards, transgender youth in Montana can rest easier tonight, knowing they can continue to flourish without this impending threat.”